Application for the Commonwealth Seniors Health Card (CSHC)

Form ID
D3056
Audience
General

Use this form to apply for the Commonwealth Seniors Health Card (CSHC).

The Commonwealth Seniors Health Card provides you with access to Pharmaceutical Benefits Scheme, certain Medicare services and specific rail travel at a cheaper rate.

If you are using an Apple computer and want to fill out your form electronically, please download the form and open it with Acrobat 7 or later.

How can I access this form?
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Form (PDF or Word)